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General NPI Number Information
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NPI Number | 1689459000
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Entity Type | Organization
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Legal Business Name | IGNITE HEALTH AND WELLNESS LLC
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Dates
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Enumeration Date | 08/25/2023
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Last Update Date | 08/25/2023
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Provider Practice Location Address
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Address Line | 1035 S STATE ROAD 7 STE 315-12
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City | WELLINGTON
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State | FL
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Zip | 33414-6134
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Country | US
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Telephone | 561-462-7908
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Fax | 561-489-6805
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Provider Business Mailing Address
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Address Line | 1035 S STATE ROAD 7 STE 315-12
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City | WELLINGTON
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State | FL
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Zip | 33414-6134
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Country | US
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Telephone | 561-462-7908
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Fax | 561-489-6805
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Authorized Official
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Title or Position | NP
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Name | DR. BETTY C. CHUKWUMA
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Credential | NP
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Telephone | 156-130-9937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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